Medical unions in the United Kingdom have criticised a proposed 2.4 per cent pay increase for doctors in the 2027/2028 financial year, warning that the offer falls short of inflation and could trigger renewed industrial disputes across the National Health Service (NHS).
The proposal was presented by the Department of Health and Social Care (DHSC) and NHS England to the independent Review Body on Doctors’ and Dentists’ Remuneration (DDRB), which advises the government on doctors’ salaries.
However, the recommendation has drawn strong opposition from unions, who argue that the proposed increase would further weaken the purchasing power of medical professionals already struggling with years of pay erosion and rising living costs.
Dr Tom Dolphin, chairman of the British Medical Association (BMA) Council, accused the government of failing to recognise the contribution of doctors amid persistent problems in the health sector, including lengthy waiting lists, delays in securing general practitioner appointments and patients receiving treatment in hospital corridors and car parks.
He maintained that doctors’ earnings remain significantly below their levels two decades ago, arguing that the profession has suffered substantial salary losses over the period.
The BMA also warned that a below-inflation settlement could worsen the shortage of medical personnel, discourage doctors from remaining in the country and undermine efforts to improve patient care. According to the association, the government’s approach to staffing could also raise concerns about patient safety if non-medical workers are used to replace doctors primarily to reduce costs.
Meanwhile, Unison, another major trade union representing health workers, raised concerns about the wider financial difficulties facing NHS employees. Its head of health, Helga Pile, said more than 200,000 NHS workers earn below the real living wage.
Pile argued that the proposed increase would do little to ease the pressure on staff facing rising household expenses, particularly with the traditionally demanding winter period approaching.
The unions’ objections come as the health service continues to grapple with financial pressures, including higher inflation, energy costs, the consequences of industrial action and declining income from the immigration health surcharge.
The government and NHS England have indicated that the proposed adjustment could be accommodated without forcing reductions in other major health commitments. However, the financial implications of staff pay remain a significant concern, with estimates suggesting that every additional 0.5 percentage point increase in NHS pay costs approximately £750 million.
That amount, according to the submission to the pay review body, is comparable to the cost of more than 89,000 hip or knee replacement operations.
The dispute follows the government’s acceptance of a 3.5 per cent pay increase for doctors in 2026, higher than its original proposal of 2.5 per cent.
The BMA has urged the independent review body to assess the needs of doctors and patients rather than allow the government’s financial position to determine the outcome.
With some groups of doctors already involved in disputes and hospital consultants in England holding a mandate for strike action, unions fear that another unsatisfactory pay settlement could lead to further disruption of medical services.
The final recommendation is expected to be a crucial test of the government’s relationship with healthcare workers, as concerns grow over staff retention, working conditions and the future capacity of the NHS to deliver timely treatment.
